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Mountain First-aid and Medicine

Heart attack

It is wrongly supposed that active persons run a low risk of having a heart attack. During our expeditions we have, unfortunately, experienced quite the opposite; even a 30-years-old suffered one in an occasion. A person without knowledge cannot make the difference between an angina pectoris and a heart attack, so in case of doubts, it should always be supposed that we are facing a heart attack. Nonetheless, people with angina are generally aware of their condition (a feeling of tightness in the chest) and carry the adequate medicine with them (nitroglycerine in capsules or spray). In an infarct of the heart, the total shutoff of one or more of the coronary vessels is produced, leading to an oxygen deficiency. This produces the necrosis of the affected myocardium.

Symptoms

  • Strong chest pain.
  • Blue lips due to the lack of oxygen.
  • Vomiting.
  • Anxiety, cold sweat, pallor, weakness.
  • In occasions, pain in the arm, back and/or abdomen; feeling of tightness in the neck.
  • Diabetics usually have no detectable symptoms.

Measures

  • Avoid any movements, to keep oxygen consumption low.
  • The damaged heart can no longer transport enough blood. To reduce the blood accumulation around the heart caused by this condition, the patient must be placed with the trunk raised.
  • High altitude expeditions (Atacama, Tupungato volcano) should always carry oxygen, for safety reasons. In case of a heart attack, it can be applied at a rate of 6-8 lt/min.
  • In case of heart failure, cardiac massage and artificial respiration should immediately start.
  • Transport the patient quickly and with extreme care, if at all possible, by helicopter.

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